Brain Donation Assistance Program | Page 6

Steps for Brain Donation

I have decided to donate my( or my family member’ s) brain. What are the next steps?
1. Enroll in the CurePSP Brain Donation Assistance Program as far in advance as possible by completing the attached documents and follow the directions outlined at the top of each page.
• Mail, email, or fax pages 9-14( page 15 is optional) to the Mayo Clinic Brain Bank:
Rachel LaPaille-Harwood, Neuropathology Program Coordinator Mayo Clinic 4500 San Pablo Road Birdsall Building, Room 310 Jacksonville, FL 32224 Email: lapaille-harwood. rachel @ mayo. edu Phone: 904-953-2439 Fax: 904-953-7117
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• Additionally, you should share page 12( the Medical Release form) with the patient’ s neurologist or physician of record so that they may send relevant medical notes to the Mayo Clinic. It is preferred that this step is done in advance while the patient is still alive. Please be aware that if you are requesting records after the patient has passed, facilities may require additional documentation, such as a copy of the death certificate or court documents showing who is the legal executor of the estate.
• Keep all copies in a safe and easily accessible location.
2. As detailed in the“ Questions and Answers” section, contact Rachel LaPaille-Harwood of the Mayo Clinic Brain Bank at lapaille-harwood. rachel @ mayo. edu or 904-953-2439, to confirm receipt of documents and to obtain information on pathologists / dieners in your area.
3. Once you have been provided information of pathologists / dieners, reach out to them to discuss the following:
• Explain the brain donation program / process and inquire if they would be able and willing to perform the brain tissue procurement and shipment.
– If they have questions regarding the tissue procurement and shipment, or the protocol for these steps, direct them to page 14 of this packet( which they will also receive at the time of brain donation) and suggest they speak directly with the Mayo Clinic Brain Bank.
• Inquire about: – Their fee, as well as their payment process. Ask if there are hours they do not work or if their fee will change depending on the time of day or day of the week.
– Direct contact information for who to call at the time of death. – The location of where they are able to perform the brain tissue procurement.